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The study addresses staffing and workforce issues for home‐ and community‐based long‐term care in Germany. It is based on a study aimed at developing staffing recommendations for home‐care provider organisations. The study was commissioned within the regulation of the German long‐term care act. Following an exploratory literature search on staffing issues in home‐ and community‐based care qualitative interviews with 30 experts in home care were conducted. In addition, time needed for different interventions in homes of people in need of care (n = 129) was measured. Ethical approval for the study was obtained. The literature on the topic is limited. In Germany, no fixed staff‐to‐client ratio exists, but staffing is determined primarily by reimbursement policies, not by care recipients’ needs. The results of the interviews indicated that staffing ratios are not the main concern of home‐care providers. Experts stressed that general availability of staff with different qualification levels and the problems of existing regulation on services and their reimbursement are of higher concern. The measurement of time needed for selected interventions reveals the huge heterogeneity of home‐care service delivery and the difficulty of using a task‐based approach to determine staffing levels. Overall, the study shows that currently demand for home‐care exceeds supply. Staff shortage puts a risk to home care in Germany. Existing approaches of reimbursement‐driven determination of staffing levels have not been sufficient. A new balance between staffing, needs and reimbursement policies needs to be developed.
"The limits of my language are the limits of my mind. All I know is what I have words for" (Wittgenstein). When learning something completely new, we connect the unknown term to an already existing part of our knowledge. We can only build new ideas and insights upon an existing conceptual foundation. In the field of statistics, we educators frequently find ourselves met with great confusion when teaching novices. These students, entirely unfamiliar with even basic statistics, must connect the introduced statistical terms within their personal existing networks of largely non-statistical knowledge. Lecturers, on the other hand, who are well versed in statistics, have deeply internalized the content to be taught and its relevant context. The juxtaposition of the two roles may produce amusement in a lecturer upon gaining insight into the word associations made by the statistical novices. For example, a ‘logistic regression’ does not involve the ‘shipping of goods in economically difficult times,’ though this might seem entirely reasonable and intuitive to the statistics learner. Other times, these different perspectives can lead to headaches and frustration for both learners and their lecturers. In this article, we illustrate how simple statistical terms are initially connected to a student’s pre-exiting knowledge and how these associations change after completing an introductory course in applied statistics. Furthermore, we emphasize the important difference between “term”, “approach”, and “context”. Understanding this fundamental distinction may help improve the communication between the lecturer and the learner. We offer a collection of practical tools for instructors to help promote students’ conceptual understanding in a supportive, mutually-beneficial learning environment.
The current study presents a new class of functional derivatives (1–3) consisting of a dicationic viologen (4,4’-bipyridinium unit) (V21) capped by nucleobases thymine (NB1), adenine (NB2), thymine/adenine (NB1, NB2), and ion-paired with amphiphilic anion 3,4,5-tris(dodecyloxy)benzene sulfonate (DOBS-). The target of our work focuses on the design and synthesis of molecular building blocks in which three different functionalities are combined: chromophore (V21 unit), molecular recognition (NB unit), and thermotropic liquid crystal (DOBS unit). The resulted materials exhibit liquid crystalline properties at ambient temperature with significant particularities-induced by nucleobases in the mesogen structure. Structure–properties relationship study focuses on providing knowledge about (1) how the thermotropic, redox properties, thermochromism, or ionic conductive properties are influenced by the presence of purinic or pyrimidinic nucleobases, and (2) how effective is their ability to selfassembly by hydrogen bonding in nonpolar solvents. The presence of nucleobases has been proved to have a substantial impact on electron transfer rate during the reduction of viologen moieties by intermolecular aggregation. Ionic conductivity and thermochromic properties of derivatives 1–3 were investigated and compared to a non-containing nucleobase analog methyl viologen with 3,4,5 tris(dodecyloxy)benzene sulfonate anion (MV) as reference.
Social networking technologies such as social media, crowd concepts, or gamification represent key resources for the integration of customers, value network partners, and the community into sustainable business models. However, there is a lack of understanding of how sustainable enterprises apply such technologies. To close this gap, we propose a taxonomy of design options for social networking technologies in sustainable business models. Our taxonomy comprises eight dimensions that deal with relevant questions of the design of social networking technologies. When creating our taxonomy, we built on existing literature and use cases and involved experienced practitioners in the field of sustainable business models for the validation of our taxonomy. In this way, our study contributes to knowledge on the use of social networking technologies in sustainable business models and how such technologies influence the boundaries of sustainable business models. Likewise, we provide practical insights into the use of social networking technologies in sustainable business models.
Background and Objectives
Despite the long-standing consensus on the importance of tumor size, tumor number and carcinoembryonic antigen (CEA) levels as predictors of long-term outcomes among patients with colorectal liver metastases (CRLM), optimal prognostic cut-offs for these variables have not been established.
Methods
Patients who underwent curative-intent resection of CRLM and had available data on at least one of the three variables of interest above were selected from a multi-institutional dataset of patients with known KRAS mutational status. The resulting cohort was randomly split into training and testing datasets and recursive partitioning analysis was employed to determine optimal cut-offs. The concordance probability estimates (CPEs) for these optimal cut offs were calculated and compared to CPEs for the most widely used cut-offs in the surgical literature.
Results
A total of 1643 patients who met eligibility criteria were identified. Following recursive partitioning analysis in the training dataset, the following cut-offs were identified: 2.95 cm for tumor size, 1.5 for tumor number and 6.15 ng/ml for CEA levels. In the entire dataset, the calculated CPEs for the new tumor size (0.52), tumor number (0.56) and CEA (0.53) cut offs exceeded CPEs for other commonly employed cut-offs.
Conclusion
The current study was able to identify optimal cut-offs for the three most commonly employed prognostic factors in CRLM. While the per variable gains in discriminatory power are modest, these novel cut-offs may help produce appreciable increases in prognostic performance when combined in the context of future risk scores.
The Lingen equilibrium model
(2021)
Equilibria protect against crisis. All disciplines of sciences have the objective to create equilibria. But economics are not successful in this point. Here a simple equilibrium model based on a wage-price-rule is demonstrated. Economics are able to create economic equilibria by using this rule. But in economic systems there are a lot of rules, especially in accounting, which make economic equilibria impossible. These rules must be changed. If it is possible to create economic equilibria, the side-effect is the realization of economic sustainability.
Objective: To understand the meaning of the Learning Incubator as a teaching and learning technology in the nursing area.
Method: Qualitative research, supported by grounded theory. Data was collected from March to November 2019, through interviews with guiding questions and hypotheses directed at two different groups. The analysis was done by comparative data analysis and included open, axial and integrated coding, as proposed by the method. The theoretical sample included 23 participants, which were nurses, technicians, and nursing students.
Results: The delimitation of the categories converged in the phenomenon (Re)signifying knowledge and practices in the Learning Incubator. Guided by the paradigmatic model, the categories were named according to the three following components: Condition: Recognizing that the being and the professional practice are inextricable; Action/interaction: Revisiting professional practices that are repetitive and mechanic; Consequence: Referring to the reflections and knowledge constructed in the Learning Incubator.
Conclusion: The Learning Incubator, as seen by the study participants, is not limited to the Incubator meetings or the themes addressed in it. Beyond a welcoming physical space, the Incubator expands itself and becomes a tool that promotes self-reflection and self-assessment of professional behaviors and attitudes.
Objective:
To understand the meaning of entrepreneurial nursing care as inducer of healthy practices in vulnerable communities.
Method:
Grounded theory, whose data collection took place between March and December 2019, from interviews with 19 participants from the central region of Rio Grande do Sul, Brazil and comparative data analysis.
Results:
The phenomenon was delimited: Experiencing small/big transformations in the invisibility of everyday life in promoting healthy practices in vulnerable communities. Conducted by the paradigmatic model, the categories were named based on the components: Condition: Making choices and negotiating non-negotiable exchanges; Action/interaction: Motivating oneself to maintain basic human needs; Consequence: Broadening perspectives and transcending personal and collective boundaries.
Conclusion:
Entrepreneurial nursing care as inducer of healthy practices in vulnerable communities is not reduced to a scientific theory or to the linear and decontextualized apprehension of healthy living, but extends to reach small/big transformations that occur in the invisibility of everyday life.
Background:
Large health organizations often struggle to build complex health information technology (HIT) solutions and are faced with ever-growing pressure to continuously innovate their information systems. Limited research has been conducted that explores the relationship between organizations’ innovative capabilities and HIT quality in the sense of achieving high-quality support for patient care processes.
Objective:
The aim of this study is to explain how core constructs of organizational innovation capabilities are linked to HIT quality based on a conceptual sociotechnical model on innovation and quality of HIT, called the IQHIT model, to help determine how better information provision in health organizations can be achieved.
Methods:
We designed a survey to assess various domains of HIT quality, innovation capabilities of health organizations, and context variables and administered it to hospital chief information officers across Austria, Germany, and Switzerland. Data from 232 hospitals were used to empirically fit the model using partial least squares structural equation modeling to reveal associations and mediating and moderating effects.
Results:
The resulting empirical IQHIT model reveals several associations between the analyzed constructs, which can be summarized in 2 main insights. First, it illustrates the linkage between the constructs measuring HIT quality by showing that the professionalism of information management explains the degree of HIT workflow support (R²=0.56), which in turn explains the perceived HIT quality (R²=0.53). Second, the model shows that HIT quality was positively influenced by innovation capabilities related to the top management team, the information technology department, and the organization at large. The assessment of the model’s statistical quality criteria indicated valid model specifications, including sufficient convergent and discriminant validity for measuring the latent constructs that underlie the measures of HIT quality and innovation capabilities.
Conclusions:
The proposed sociotechnical IQHIT model points to the key role of professional information management for HIT workflow support in patient care and perceived HIT quality from the viewpoint of hospital chief information officers. Furthermore, it highlights that organizational innovation capabilities, particularly with respect to the top management team, facilitate HIT quality and suggests that health organizations establish this link by applying professional information management practices. The model may serve to stimulate further scientific work in the field of HIT adoption and diffusion and to provide practical guidance to managers, policy makers, and educators on how to achieve better patient care using HIT.
The ability of film stars to attract viewers is a widely accepted rationale for hiring expensive actors. However, the precise mechanisms behind this ‘drawing power’ remain unclear. By reviewing the existing literature, six possible antecedents of drawing power are identified. Artists with high acting abilities (i) increase a film’s artistic appeal, (ii) function as markers of quality and (iii) facilitate the matching process with the right audiences. Widely popular, commonly perceived as beautiful/handsome but often less talented actors, on the other hand, rather (iv) facilitate the marketing campaigns of films, (v) offer entertaining interactions with famous personalities and (vi) provide manifold opportunities for gossiping. Based on a discussion of the implications for theory and a preliminary analysis of a sample of Hollywood actors, managerial recommendations for those who have and those who depend on star drawing power are developed.
The way in which brands are economically represented in the context of financial reporting is controversial in theory and practice. This holds especially against the background of the ever- increasing importance of intangible assets. Brands and the economic success associated with them are thus regarded as a key variable for overall corporate success: cash flows can be accelerated and expanded through the use of brand-strategic options, while existing risks may be mitigated. In addition to a large number of theoretical definitions, the determination of brand value from both a marketing and an accounting perspective is also characterized by a complex interaction of numerous influencing factors. This is where the International Accounting Standards IAS 38: "Intangible Assets" (isolated acquisition of a brand) and IFRS 3: "Business Combinations" (acquisition of a brand as part of a business combination) take effect: These are intended to ensure a comparable and reliable "true and fair view" for the presentation of intangible assets in international accounting. In addition to various recognition criteria, the accounting regulation here also includes the accounting valuation of intangible assets and thus also of brands. In principle, valuation in accordance with IAS 38 is based on acquisition costs. The determination of the operating life for impact evaluation is highly controversial both in literature and in practice. Under IFRS 3, acquisition costs are to be replaced by the fair value. Regardless of the method used, possible subjectivity is one of the central issues. The current discussion approach of the International Accounting Standards Board also clearly shows the need for simplification and concretization that still exists for practice: In particular, the accounting distinction between goodwill and intangible assets is the subject of discussions with the Global Preparers Forum, among others. The interests of users, preparers and auditors of corporate financial reporting must be taken into account equally. In particular, the prohibition on recognizing self-created brands in the balance sheet makes it difficult to assess their value. Furthermore, it creates a weak point in the presentation of the true and fair view of a company's financial position and financial performance that is generally required. Regardless of the previous, the current rules provide preparers and users with a basic overview of existing intangible assets. Irrespective of how valuation is determined individually, the IASB's rules thus help to create a fundamental structure. In which approach the future discussion will result in remains open.
Der Konsumbereich „Ernährung“ verantwortet in Deutschland rund 15 % der Treibhausgasemissionen (THG). Aufgrund der hohen Nachfrage hat die Außer-Haus-Verpflegung eine starke Hebelwirkung, um eine klimaeffiziente Ernährung voranzutreiben – so auch Schulküchen. Aktuell sind der Verpflegung jedes Schulkindes, welches ganzjährig an der Mittagsverpflegung teilnimmt, pro Jahr etwa 264 kg THG-Emissionen zuzuschreiben.
Im Projekt KEEKS „Klima- und energieeffiziente Küche in Schulen” wurden deshalb in 22 Schulküchen von Ganztagsschulen mit täglich insgesamt 5 000 Mittagessen der Status Quo ermittelt. Dies geschah mittels Energiemessungen, Analyse von Ausstattung, Technik und Prozessen der Küchen sowie leitfadengestützten Interviews mit den Küchenleitungen. Treibhausgasemissionen von Menüs und Küchenprozessen wurden bilanziert, Einsparpotenziale identifiziert sowie Handlungsempfehlungen entwickelt und erprobt. Die effektivsten Maßnahmen – die Reduktion und Substitution von Fleisch und Fleischprodukten sowie der Aufbau eines effizienten Abfallmanagements – sparen rund 10 % des Treibhausgasausstoßes einer Schulküche ein. Die erarbeiteten Handlungsempfehlungen können Küchenpersonal dabei unterstützen, eine klimafreundliche, kindgerechte, gesunde und bezahlbare Schulküche zu gestalten.
Objective:
The cervical mucus plugs are enriched with proteins of known immunological functions. We aimed to characterize the anti-HIV-1 activity of the cervical mucus plugs against a panel of different HIV-1 strains in the contexts of cell-free and cell-associated virus.
Design:
A cohort of consenting HIV-1-negative and HIV-1-positive pregnant women in labour was recruited from Mthatha General Hospital in the Eastern Cape province of South Africa, from whom the cervical mucus plugs were collected in 6 M guanidinium chloride with protease inhibitors and transported to our laboratories at −80 °C.
Methods:
Samples were centrifuged to remove insoluble material and dialysed before freeze--drying and subjecting them to the cell viability assays. The antiviral activities of the samples were studied using luminometric reporter assays and flow cytometry. Time-of-addition and BlaM-Vpr virus-cell fusion assays were used to pin-point the antiviral mechanisms of the cervical mucus plugs, before proteomic profiling using liquid chromatography-tandem mass spectrometry.
Results:
The proteinaceous fraction of the cervical mucus plugs exhibited anti-HIV-1 activity with inter-individual variations and some degree of specificity among different HIV-1 strains. Cell-associated HIV-1 was less susceptible to inhibition by the potent samples whenever compared with the cell-free HIV-1. The samples with high antiviral potency exhibited a distinct proteomic profile when compared with the less potent samples.
Conclusion:
The crude cervical mucus plugs exhibit anti-HIV-1 activity, which is defined by a specific proteomic profile.
Green roofs are known to mitigate the negative effects of urban consolidation by offering diverse ecosystem functions compared to non-vegetated roofs. However, the support for native biodiversity might be improved by using native plant species. In a mesocosm experiment, we studied the suitability of three commercial green-roof growth substrates for the establishment of 27 native plant species from dry sandy grasslands of northwestern Germany over the course of four years. The substrates were mineral-based, but differed in the layering of organic matter. Total establishment rates reached 44–59% in Year 4, indicating the general suitability of the substrates. During the first weeks after seeding, with light irrigation, the vascular plant cover was greater in the similar substrates Zincolit® Plus (Z) and Zincolit® Plus-Leicht (ZL) with their compost-based organic mulch layers than in the substrate Sedumteppich (ST) with its organic matter evenly admixed with the mineral aggregates. In Years 2 and 3, however, the vascular plant cover was greater in the ST substrate, likely due to the better availability of water and nutrients from the organic matter compared to the dry surface-mulch layer variants Z and ZL. After severe drought events, the decline in plant cover was more pronounced in the ST substrate, likely representing a trade-off between lush growth and a susceptibility to drought. An indicator-species analysis revealed differences in species composition between the ST and Z/ZL substrates. Annual plant species were indicators of the ST substrate. Perennials, such as Thymus pulegioides and Achillea millefolium, were typical of the Z and ZL substrates. In addition to the general suitability of the tested standard substrates for target species establishment, the study indicated that a combination of different layers of substrate components resulted in different vegetation patterns that may have a positive effect on green-roof biodiversity.
Guided by cultural labor economics, the paper analyzes the career paths of former actors from popular television soap operas, and addresses in particular, if and under which conditions such serial engagements may function as a stepping stone for a subsequent professional acting career. A novel database of 396 German artists with detailed and long-term biographical information is used for the quantitative empirical analyses. The results indicate that soaps, contrary to popular opinion, function as a stepping stone, especially for younger actors. However, soap engagements should be rather short but long enough to allow artists to play multiple roles in other shows or films besides being in the cast of a soap. While formal acting education does not influence soap actors’ future filmographies, there is evidence that it helps artists to find jobs in arts-related occupations such as voice acting. Finally, publicity and media presence foster a later acting career. Practical implications for artists and their managers are outlined, along with a discussion on the meaning of serials for the creation and commercialization of stars.
This chapter provides an overview of the gender aspects that are relevant to Talent Management, acknowledging gender as a social construction of the purportedly adequate behaviors and traits exhibited by males and females as the result of education and socialization processes. It discusses gendered perspectives and the needs of current and future key players, such as work–family balance and dual-career challenges, because they influence the decisions of talent to join, remain with, or leave organizations. The chapter focuses on well-qualified female professionals who are willing to invest in themselves and value their significant involvement in their work. By applying a gender lens, it addresses a gap in the Talent Management discussion and aims to contribute to the development of Talent Management on both the theoretical and practical level. If Talent Mangement systematically includes employees in mid- and late career and enables them to learn throughout their careers, it will expand its target groups.
In recent years, various studies have highlighted the opportunities of artificial intelligence (AI) for our society. For example, AI solutions can help reduce pollution, waste, or carbon footprints. On the other hand, there are also risks associated with the use of AI, such as increasing inequality in society or high resource consumption for computing power. This paper explores the question how corporate culture influences the use of artificial intelligence in terms of sustainable development. This type of use includes a normative element and is referred to in the paper as sustainable artificial intelligence (SAI). Based on a bibliometric literature analysis, we identify features of a sustainability-oriented corporate culture. We offer six propositions examining the influence of specific manifestations on the handling of AI in the sense of SAI. Thus, if companies want to ensure that SAI is realized, corporate culture appears as an important indicator and influencing factor at the same time.
The study aimed for the analysis of the impact of pulsed electric field (PEF) pre-treatment on convection (CD) and microwave (MW-CD) assisted air drying. Drying kinetics acceleration and retention of bioactive compounds of PEF pre-treated carrots and apples has been demonstrated. Moreover, the direct and indirect environmental energy impacts of CD and MW-CD technologies with consideration of bioactive compounds preservation has been evaluated. PEF assisted CD and MW-CD demonstrated lower energy use, especially for indirect energy consumption, in the case of carotenoids preservation in dried carrots.
Container-based lightweight buildings offer a high ecologic and economic potential when they are designed as nearly zero-energy container buildings (NZECBs). Thus, they are relevant to energy transition in achieving an almost climate-neutral building stock. This paper describes and applies design strategies for suitable building concepts and energy systems to be used in NZECBs for different climates. Therefore, different applications in representative climatic zones were selected. Initially, the global climate zones were characterized and analyzed with regard to their potential for self-sufficiency and renewable energies in buildings. The design strategies were further developed and demonstrated for three cases: a single-family house in Sweden, a multi-family house in Germany, and a small school building in rural Ethiopia. For each case, design guidelines were derived and building concepts were developed. On the basis of these input data, various energy concepts were developed in which solar and wind energy, as well as biomass, were integrated as renewable energy sources. All the concepts were simulated and analyzed with the Polysun® software. The various approaches were compared and evaluated, particularly with regard to energy self-sufficiency. Self-sufficiency rates up to 80% were achieved. Finally, the influence of different climate zones on the energy efficiency of the single-family house was studied as well as the influence of the size of battery storage and insulation.
As allergy towards apples is widespread, the evaluation of various cultivation and postharvest influences on the allergenic potential is of great importance. Therefore, the analysis of the Mal d 1 content was the focus of this study, originally dealing with investigating the influence of a selenium biofortification on apple quality. The Mal d 1 content of apples was in most cases reduced when the fruits were biofortified with selenium. Apple variety and climatic conditions were identified as further influencing factors for the Mal d 1 content of the fruits. The separate analysis of the peel and the fruit flesh showed that the content of Mal d 1 in the fruit flesh was significantly lower in the biofortified samples than in the controls. In conclusion, the results indicate that the selenium biofortification of apples and biochemical mechanism behind can reduce the allergenic potential regarding the content of Mal d 1.
Green roofs can mitigate negative environmental effects of urban densifcation to some extent, but they are often covered by species-poor Sedum mixtures with a low value for biodiversity. By combining a habitat template and a seedprovenance approach, we review the suitability of plant species from regionally occurring dry sandy grasslands (Koelerio-Corynophoretea) for extensive roof greening in northwestern Germany. Since 2015, we have studied the effects of species introduction on vegetation dynamics on experimental mini-roofs. Treatments included sowing seeds of regional native origin in two densities (1 g and 2 g/m2) and the transfer of raked material from an ancient dry grassland area classifed as Natura 2000 site. The applied raked material contained diaspores of 27 vascular plant species (including seven threatened species) and vegetative fragments of grasslandspecifc mosses and lichens. Since 2018, we have tested more species-rich seed mixtures in a large-scale experiment on a roof of 500 m2 with different engineered green-roof substrates and layering. In 2019, a green roof of 10,200 m2 was established in cooperation with a local enterprise to support regional native biodiversity.
In this chapter, we summarise the most important results of our studies and discuss how to support regional native biodiversity on green roofs.
Notable parts of the population in Europe suffer from allergies towards apples. To address this health problem, the analysis of the interactions of relevant allergens with other substances such as phenolic compounds is of particular importance. The aim of this study was to evaluate the correlations between the total phenolic content (TPC), polyphenol oxidase (PPO) activity, antioxidant activity (AOA), and the phenolic compound profile and the content of the allergenic protein Mal d 1 in six apple cultivars. It was found that the PPO activity and the content of individual phenolic compounds had an influence on the Mal d 1 content. With regard to the important constituents, flavan-3-ols and phenolic acids, it was found that apples with a higher content of chlorogenic acid and a low content of procyanidin trimers and/or epicatechin had a lower allergenic potential. This is probably based on the reaction of phenolic compounds (when oxidized by the endogenous PPO) with proteins, thus being able to change the conformation of the (allergenic) proteins, which further corresponds to a loss of antibody recognition. When apples were additionally biofortified with selenium, the composition of the apples, with regard to TPC, phenolic profile, AOA, and PPO, was significantly affected. Consequently, this innovative agronomic practice seems to be promising for reducing the allergenic potential of apples.
Rationale:
Performing artists are exposed to high strains during their performance. These strains are similar to the ones of professional athletes, but in contrast to athletes there is a comprehensive undersupply of care regarding preventive and rehabilitative therapy offers.
Purpose:
The purpose of RefLabPerform is to develop a reference laboratory for the assessment of neuromusculoskeletal disorders using physiotherapeutic assessment methods in combination with biomechanical motion analysis. This includes the automatized integration of the physiotherapeutic assessments with the technical biomechanical analysis for an individual treatment recommendation with decentralized health care recommendations for a home-based therapy based on evidence-based prevention and rehabilitation strategies.
Methods:
Several work packages are processed systematically, whereby according to the requirements in the course of the project an overlapping of work packages occurs. First, the component planning of the innovative reference laboratory structure is carried out, on which the clinical and technical development of the reference laboratory is based. The next steps are the development of individual clinical assessment protocols, prevention and rehabilitation strategies as well as the setup of the laboratory and the development of technical routines. Parallel to this, various analysis tools are being developed for biomechanical data as well as for physiotherapeutic diagnostics and merged at the end of this work package for individual results for different groups of performing artists. Overlapping with the previous work packages, the reference laboratory will be tested for application and manageability. Clinical and technical data are brought together and checked by means of individual case trials on various groups of artists. In terms of an agile software development process, the results flow back into the previous work packages in order to optimize them and then test them again.
Results:
At the end of the project a functional and proven reference laboratory for the comprehensive analysis of performing artists will be developed.
Conclusions:
This reference laboratory is specialized to the diagnosis and treatment of playing- and performance-related dysfunctions with a focus on clinical findings and biomechanical movement analysis.
Educational Objectives:
At the end of the presentation, the participants will be able to…
1. describe the innovative content of the project RefLabPerform
2. understand the advantages of merged analysis strategies by physiotherapeutic and biomechanical examinations
3. understand the complex interdisciplinary process to develop a reference laboratory for performing artists
Rationale:
Performing artists are exposed to high strains during their performance. These strains are similar to the ones of professional athletes, but in contrast to athletes there is a comprehensive undersupply of care regarding preventive and rehabilitative therapy offers.
Purpose:
The purpose of RefLabPerform is to develop a reference laboratory for the assessment of neuromusculoskeletal disorders using physiotherapeutic assessment methods in combination with biomechanical motion analysis. This includes the automatized integration of the physiotherapeutic assessments with the technical biomechanical analysis for an individual treatment recommendation with decentralized health care recommendations for a home-based therapy based on evidence-based prevention and rehabilitation strategies.
Methods:
Several work packages are processed systematically, whereby according to the requirements in the course of the project an overlapping of work packages occurs. First, the component planning of the innovative reference laboratory structure is carried out, on which the clinical and technical development of the reference laboratory is based. The next steps are the development of individual clinical assessment protocols, prevention and rehabilitation strategies as well as the setup of the laboratory and the development of technical routines. Parallel to this, various analysis tools are being developed for biomechanical data as well as for physiotherapeutic diagnostics and merged at the end of this work package for individual results for different groups of performing artists. Overlapping with the previous work packages, the reference laboratory will be tested for application and manageability. Clinical and technical data are brought together and checked by means of individual case trials on various groups of artists. In terms of an agile software development process, the results flow back into the previous work packages in order to optimize them and then test them again.
Results:
At the end of the project a functional and proven reference laboratory for the comprehensive analysis of performing artists will be developed.
Conclusions:
This reference laboratory is specialized to the diagnosis and treatment of playing- and performance-related dysfunctions with a focus on clinical findings and biomechanical movement analysis.
Educational Objectives:
At the end of the presentation, the participants will be able to…
1. describe the innovative content of the project RefLabPerform
2. understand the advantages of merged analysis strategies by physiotherapeutic and biomechanical examinations
3. understand the complex interdisciplinary process to develop a reference laboratory for performing artists
The effects of reaction parameters on Hurn:xwiley:23670932:media:cptc202000216:cptc202000216-math-0001 production from ethanol photocatalysis in the gas phase have been investigated. The photocatalytic activity evolves from an early mass‐transfer limited regime to an independent one at later irradiation times, which is interpreted in terms of a photocatalytic site activity distribution. Ethanol molar fraction exhibits two different domains, with Hurn:xwiley:23670932:media:cptc202000216:cptc202000216-math-0002 production increasing up to a molar fraction of 0.12, beyond which it plateaus. Hurn:xwiley:23670932:media:cptc202000216:cptc202000216-math-0003 :AcH ratios are very sensitive to reaction conditions, reaching 1.8 at low reactant flows. UV light is converted to Hurn:x-wiley:23670932:media:cptc202000216:cptc202000216-math-0004 with an efficiency of nearly 3 %.
Background
A pre-existing neurocognitive disorder (NCD) is a relevant factor for the outcome of surgical patients. To improve understanding of these conditions, we investigated the association between parameters of the cholinergic system and NCD.
Method
This investigation is part of the BioCog project (www.biocog.eu), which is a prospective multicenter observational study including patients aged 65 years and older scheduled for elective surgery. Patients with a Mini-Mental State Examination (MMSE) score ≤23 points were excluded. Neurocognitive disorder was assessed according to the fifth Diagnostic and Statistical Manual of Mental Disorders criteria. The basal forebrain cholinergic system volume (BFCSV) was assessed with magnetic resonance imaging, the peripheral cholinesterase (ChE) activities with point-of-care measurements, and anticholinergic load by analyzing the long-term medication with anticholinergic scales (Anticholinergic Drug Scale [ADS], Anticholinergic Risk Scale [ARS], Anticholinergic Cognitive Burden Scale [ACBS]). The associations of BFCSV, ChE activities, and anticholinergic scales with NCD were studied with logistic regression analysis, adjusting for confounding factors.
Results
A total of 797 participants (mean age 72 years, 42% females) were included. One hundred and eleven patients (13.9%) fulfilled criteria for mild NCD and 82 patients (10.3%) for major NCD criteria. We found that AcetylChE activity was associated with major NCD (odds ratio [95% confidence interval]: [U/gHB] 1.061 [1.010, 1.115]), as well as ADS score ([points] 1.353 [1.063, 1.723]) or ARS score, respectively ([points] 1.623 [1.100, 2.397]) with major NCD. However, we found no association between BFCSV or ButyrylChE activity with mild or major NCD.
Conclusions
AcetylChE activity and anticholinergic load were associated with major NCD. Future research should focus on the association of the cholinergic system and the development of postoperative delirium and postoperative NCD.
In this experimental work, the quasi static and fatigue properties of a 40 wt.% long carbon fiber reinforced partially aromatic polyamide (Grivory GCL-4H) were investigated. For this purpose, microstructural parameter variations in the form of different thicknesses and different removal directions from injectionmolded plates were evaluated. Mechanical properties decreased by increasing misalignment away from the melt flow direction. By changing the specimen thickness, no change in the general fiber distribution pattern transversal and normal to the axis of melt flow was observed. It has shown that with increasing specimen thickness the quasi static properties along the melt flow direction decreased and vice versa resulting in superior properties normal to the melt flow axis. At around 5 mm, an intersection suggests quasi-isotropic behavior. In addition, the fatigue strength of the material was significantly higher in the flow direction than normal to the flow direction. No change in fatigue life was observed while changing specimen thickness. The Basquin equation seems to describe the effect of stress amplitude on the fatigue strength of this composite. Scanning electron microscopy was used to investigate fracture surfaces of tested specimens. Results show that mechanical properties and morphological structures depend highly on fiber orientation.
Long Range Wide Area Network (LoRaWAN) operates in the ISM band with 868 MHz, where the Time on Air (ToA) is regulated in the EU to 1 %. LoRaWAN nodes use the Adaptive Data Rate (ADR) algorithm to adapt their data rates during operation. The standard ADR algorithm works well with stationary nodes, however is very slow in the adaptation for mobile nodes. This paper introduces a new ADR algorithm for LoRaWAN that is supported by higher level meta-data for sensor streams, namely Quality of Information (QoI). With the help of QoI it is possible to provide additional information to the new ADR algorithm, reducing the convergence time and thus improving the Packet Delivery Ratio (PDR) of data from mobile sensor nodes. The new algorithm requires only modifications on network server side and keeps backwards compatibility with LoRaWAN nodes. Results show a significant better PDR compared to the standard ADR in scenarios with a limited number of mobile nodes.
Quantitative Umweltbewertungen sind von entscheidender Bedeutung, wenn es darum geht, effektiv auf nachhaltige Produktions- und Verbrauchsmuster hinzuarbeiten. In den letzten Jahrzehnten haben sich Lebenszyklusanalysen (LCA) als praktikables Mittel zur Messung der Umweltauswirkungen von Produkten entlang der Lieferkette etabliert. In Bezug auf Nutzer- und Konsummuster wurden jedoch methodische Schwächen festgestellt, und es wurden mehrere Versuche unternommen, Ökobilanzen entsprechend zu verbessern, beispielsweise durch Einbeziehung von Effekten höherer Ordnung und verhaltenswissenschaftlicher Unterstützung. In einer Diskussion solcher Ansätze zeigen wir, dass den Konzepten des Verbrauchs keine explizite Aufmerksamkeit geschenkt wurde, was häufig zu produktzentrierten Bewertungen führt. Wir führen Theorien sozialer Praktiken ein, um Konsummuster für LCA zugänglich zu machen. Soziale Praktiken sind routinierte Handlungen, die aus miteinander verbundenen Elementen (Materialien, Kompetenzen und Bedeutungen) bestehen, die sie als eine Einheit denkbar machen (z. B. Kochen). Da die meisten sozialen Praktiken eine Art von Verbrauch (Material, Energie, Luft) beinhalten, konnten wir einen Rahmen entwickeln, der soziale Praktiken mit der Ökobilanz verbindet. Der vorgeschlagene Rahmen bietet eine neue Perspektive für quantitative Umweltbewertungen, indem er den Schwerpunkt von Produkten oder Nutzern auf soziale Praktiken verlagert. Dementsprechend sehen wir die Chance darin, die reduktionistische Sichtweise zu überwinden, dass Menschen nur Nutzer von Produkten sind, und sie stattdessen als Praktiker in sozialen Praktiken zu sehen. Dieser Wandel könnte neue Methoden der interdisziplinären Konsumforschung ermöglichen, die beabsichtigte Sozialwissenschaften und wirkungsorientierte Bewertungen einbeziehen. Allerdings bedarf der Rahmen einer weiteren Überarbeitung und vor allem einer empirischen Validierung.
Older people, across the spectrum of life, experience socio-demographic changes that easily hinder the capacity of health and social care practitioners to promote person-centred care within this group. This chapter aims to share three case studies demonstrating the promotion of person-centred care for people with dementia in Taiwan, Germany and Australia. The case studies demonstrate interdisciplinary implementation of practice development projects by practitioners in medicine, nursing and occupational therapy in community and nursing home care settings. Claims, concerns and issues are used by facilitators to negotiate a shared interpretation among a wide range of stakeholder groups or to reach a consensus on constructions about workplace experiences. The focus on dementia demonstrated that even when working with a vulnerable population group, practitioners, service providers, non-governmental organisations and policymakers can work towards empowering service users and their family carers to achieve person-centred care experiences.
Professionalization in low-threshold drug aid : between managerialism and practitioner knowledge
(2021)
Preoperative medication use and development of postoperative delirium and cognitive dysfunction
(2021)
Postoperative delirium (POD) and postoperative (neuro-)cognitive disorder (POCD) are frequent and serious complications after operations. We aim to investigate the association between pre-operative polypharmacy and potentially inappropriate medications and the development of POD/POCD in elderly patients. This investigation is part of the European BioCog project (www.biocog.eu), a prospective multicenter observational study with elderly surgical patients. Patients with a Mini-Mental State Examination score less than or equal to 23 points were excluded. POD was assessed up to 7 days after surgery using the Nursing Delirium Screening Scale, Confusion Assessment Method (for the intensive care unit [ICU]), and a patient chart review. POCD was assessed 3 months after surgery with a neuropsychological test battery. Pre-operative long-term medication was evaluated in terms of polypharmacy (≥5 agents) and potentially inappropriate medication (defined by the PRISCUS and European list of potentially inappropriate medications [EU(7)-PIM] lists), and associations with POD and POCD were analyzed using logistic regression analysis. Eight hundred thirty-seven participants were included for analysis of POD and 562 participants for POCD. Of these, 165 patients (19.7%) fulfilled the criteria of POD and 60 (10.7%) for POCD. After adjusting for confounders, pre-operative polypharmacy and intake of potentially inappropriate medications could not be shown to be associated with the development of POD nor POCD. We found no associations between pre-operative polypharmacy and potentially inappropriate medications and development of POD and POCD. Future studies should focus on the evaluation of drug interactions to determine whether patients benefit from a pre-operative adjustment.
Background
Postoperative delirium (POD) is a frequent and serious complication after surgery. Evidence of a relationship between anticholinergic medication and the development of delirium is inconclusive, but studies on POD are rare.
Objectives
The objective of this study was to evaluate the anticholinergic load of preoperative medication in older adult patients and its association with the development of POD.
Methods
This investigation was part of the European BioCog project (http://www.biocog.eu), a prospective multicenter observational study in older adult surgical patients (ClinicalTrials.gov identifier: NCT02265263, 15 October 2014). Patients with a Mini–Mental State Examination score ≤ 23 points were excluded. POD was assessed up to 7 days after surgery using the Nursing Delirium Screening Scale, Confusion Assessment Method and a patient chart review. The preoperative anticholinergic load was calculated using the Anticholinergic Drug Scale (ADS), the Anticholinergic Risk Scale (ARS) and the Anticholinergic Cognitive Burden Scale (ACBS), and associations with POD were analyzed using logistic regression analysis adjusting for age, comorbidities, duration of anesthesia and number of drugs used.
Results
In total, 837 participants were included for analysis, and 165 patients (19.7%) fulfilled the criteria of POD. After adjusting for confounders, we found no association between preoperative anticholinergic load and the development of POD (ADS [points] odds ratio [OR] 0.928; 95% confidence interval [CI] 0.749–1.150; ARS [points] OR 0.832; 95% CI 0.564–1.227; ACBS [points] OR 1.045; 95% CI 0.842–1.296).
Conclusion
This study found no association between the anticholinergic load of drugs used preoperatively and the development of POD in older adult patients without severe preexisting cognitive impairment. Future analyses should examine the influence of intra- and postoperative administration of anticholinergic drugs as well as dosages of and interactions between medications.
High levels of meat consumption are increasingly being criticised for ethical, environmental, and social reasons. Plant-based meat substitutes have been with reservations identified as healthy sources of protein in comparison to meat. This alternative offers several social, environmental, and probably health benefits, and it may play a role in reducing meat consumption. However, there has been a lack of research on how specific meat substitute attributes can influence consumers to replace or partially replace meat in their diets. Research has demonstrated that, in many countries, consumers are highly attached to meat. They consider it to be an essential and integral element of their daily diet. For the consumers that are not interested in vegan or vegetarian alternatives to meat, so-called meathybrids could be a low-threshold option for a more sustainable food consumption behaviour. In meathybrids, only a fraction of the meat product (e.g., 20% to 50%) is replaced with plant-based proteins. In this paper, the results of an online survey with 500 German consumers are presented with a focus on preferences and attitudes relating to meathyrids. The results show that more than fifty percent of consumers substitute meat at least occasionally. Thus, approximately half of the respondents reveal an eligible consumption behaviour with respect to sustainability and healthiness to a certain degree. Regarding the determinants of choosing either meathybrid or meat, it becomes evident that the highest effect is exerted by the health perception. The healthier meathybrids are perceived, the higher is the choice probability. Thus, this egoistic motive seems to outperform altruistic motives, like animal welfare or environmental concerns, when it comes to choice for this new product category.
Selenium and iodine are essential micronutrients for humans. They are often deficient in food supply due to low phytoavailable concentrations in soil. Agronomic biofortification of food
crops is one approach to overcome micronutrient malnutrition. This study focused on a pre-launch exploration of German consumers’ willingness to purchase selenium- and/or iodine-biofortified apples. For this purpose, an online survey was carried out. In this context, consumers were asked to choose their most preferred apple product from a set card of product alternatives in a discrete choice experiment (DCE). The multinomial logit model results demonstrated that German consumers’ have a particular preference for iodine-biofortified apples. Furthermore, apple choice was mainly influenced by price, health claims, and plastic-free packaging material. Viewed individually, selenium did not exert an effect on product choice whereas positive interactions between both micronutrients exist.
Due to the resource-constrained nature of embedded systems, it is crucial to support the estimation of their power consumption as early in the development process as possible. Non-functional requirements based on power consumption directly impact the software design, e.g., watt-hour thresholds and expected lifetimes based on battery capacities. Even if software affects hardware behavior directly, these types of requirements are often overlooked by software developers because they are commonly associated with the hardware layer. Modern trends in software engineering such as Model-Driven Development (MDD) can be used in embedded software development to evaluate power consumption-based requirements in early design phases. However, power consumption aspects are currently not sufficiently considered in MDD approaches. In this paper, we present a model-driven approach using Unified Modeling Language profile extensions to model hardware components and their power characteristics. Software m odels are combined with hardware models to achieve a system-wide estimation, including peripheral devices, and to make the power-related impact in early design stages visible. By deriving energy profiles, we provide software developers with valuable feedback, which may be used to identify energy bugs and evaluate power consumption-related requirements. To demonstrate the potential of our approach, we use a sensor node example to evaluate our concept and to identify its energy bugs.
Red pepper (Capsicum annuum L.) is one of the major spices consumed globally, recognized for its aroma and nutrient properties, and it has a major economic value for high producing countries. However, characterization of its techno-functional properties and in-depth understanding of oxidative stability is needed to produce food of high quality and stability. Thus, this work focused on the chemical, functional, thermal, oxidative stability and rheological properties of red pepper powder and paste. Experiment was designed in a Completely Randomized Design (CRD) fashion. The red pepper powder contained 14.50 g/100 g, 44.00 g/100 g and 7.57 g/100 g of crude fat, crude fiber and ash, respectively. The concentration of total phenols, carotenoids and antioxidants activity of the powder were 1.04 g GAE/100 g, 374 mg βc/100 g and 38.61 μmol TE/g, respectively. Functional properties showed lower bulk density (395.1 kg/m3) and higher tapped density (583.4 kg/m3) indicating the higher compressibility of the powder. In contrast, Hausner ratio (1.48), Carr’s index (32%) and angle of repose (45°) indicated poor flowability of the powder. Particle size distribution also indicated that the volume weighted mean values D[4,3] of the powder and paste were 262.20 and 201.46, respectively. Emulsifying capacity of the powder was 47.5%. Oil and water absorption capacities varied from 1.41 to 1.73 and 0.86 to 2.29 g/g of initial weight, respectively. Higher glass transition temperature was observed for the powder (62.54°C) than the paste (45.64°C). The induction period indicated that red pepper was more stable against oxidation in powder (5.2 h) than in the paste form (3.2 h). Rheological analysis revealed that the paste exhibited shear-thinning behavior. Overall, understanding of the properties of red pepper could contribute to enhance quality.
BACKGROUND:
Intraoperative electroencephalography (EEG) signatures related to the development of postoperative delirium (POD) in older patients are frequently studied. However, a broad analysis of the EEG dynamics including preoperative, postinduction, intraoperative and postoperative scenarios and its correlation to POD development is still lacking. We explored the relationship between perioperative EEG spectra-derived parameters and POD development, aiming to ascertain the diagnostic utility of these parameters to detect patients developing POD.
METHODS:
Patients aged ≥65 years undergoing elective surgeries that were expected to last more than 60 minutes were included in this prospective, observational single center study (Biomarker Development for Postoperative Cognitive Impairment [BioCog] study). Frontal EEGs were recorded, starting before induction of anesthesia and lasting until recovery of consciousness. EEG data were analyzed based on raw EEG files and downloaded excel data files. We performed multitaper spectral analyses of relevant EEG epochs and further used multitaper spectral estimate to calculate a corresponding spectral parameter. POD assessments were performed twice daily up to the seventh postoperative day. Our primary aim was to analyze the relation between the perioperative spectral edge frequency (SEF) and the development of POD.
RESULTS:
Of the 237 included patients, 41 (17%) patients developed POD. The preoperative EEG in POD patients was associated with lower values in both SEF (POD 13.1 ± 4.6 Hz versus no postoperative delirium [NoPOD] 17.4 ± 6.9 Hz; P = .002) and corresponding γ-band power (POD −24.33 ± 2.8 dB versus NoPOD −17.9 ± 4.81 dB), as well as reduced postinduction absolute α-band power (POD −7.37 ± 4.52 dB versus NoPOD −5 ± 5.03 dB). The ratio of SEF from the preoperative to postinduction state (SEF ratio) was ~1 in POD patients, whereas NoPOD patients showed a SEF ratio >1, thus indicating a slowing of EEG with loss of unconscious. Preoperative SEF, preoperative γ-band power, and SEF ratio were independently associated with POD (P = .025; odds ratio [OR] = 0.892, 95% confidence interval [CI], 0.808–0.986; P = .029; OR = 0.568, 95% CI, 0.342–0.944; and P = .009; OR = 0.108, 95% CI, 0.021–0.568, respectively).
CONCLUSIONS:
Lower preoperative SEF, absence of slowing in EEG while transitioning from preoperative state to unconscious state, and lower EEG power in relevant frequency bands in both these states are related to POD development. These findings may suggest an underlying pathophysiology and might be used as EEG-based marker for early identification of patients at risk to develop POD.
Access to digital technologies depends on the availability of technical infrastructure, but this access is unequally distributed among social groups and newly summarized under the term digital divide. The aim is to analyze the perception of a tracing app to contain Covid-19 in Germany. The results showed that participants with the highest level of formal education rate the app as beneficial and were the most likely to use the app.
Background
Digital health technologies enable patients to make a personal contribution to the improvement of their health by enabling them to manage their health. In order to exploit the potential of digital health technologies, Internet-based networking between patients and health care providers is required. However, this networking and access to digital health technologies are less prevalent in sociodemographically deprived cohorts. The paper explores how the use of digital health technologies, which connect patients with health care providers and health insurers has changed during the COVID-19 pandemic.
Methods
The data from a German-based cross-sectional online study conducted between April 29 and May 8, 2020, were used for this purpose. A total of 1.570 participants were included in the study. Accordingly, the influence of sociodemographic determinants, subjective perceptions, and personal competencies will affect the use of online booking of medical appointments and medications, video consultations with providers, and the data transmission to health insurers via an app.
Results
The highest level of education (OR 1.806) and the presence of a chronic illness (OR 1.706) particularly increased the likelihood of using online booking. With regard to data transmission via an app to a health insurance company, the strongest increase in the probability of use was shown by belonging to the highest subjective social status (OR 1.757) and generation Y (OR 2.303). Furthermore, the results show that the higher the subjectively perceived restriction of the subjects' life situation was due to the COVID-19 pandemic, the higher the relative probability of using online booking (OR 1.103) as well as data transmission via an app to a health insurance company (OR 1.113). In addition, higher digital literacy contributes to the use of online booking (OR 1.033) and data transmission via an app to the health insurer (OR 1.034).
Conclusions
Socially determined differences can be identified for the likelihood of using digital technologies in health care, which persist even under restrictive conditions during the COVID-19 pandemic. Thus, the results indicate a digital divide with regard to the technologies investigated in this study.
The benzodiazepine, midazolam, is one of the most frequently used sedatives in intensive care medicine, but it has an unfavorable pharmacokinetic profile when continuously applied. As a consequence, patients are frequently prolonged and more deeply sedated than intended. Due to its distinct pharmacological features, including a cytochrome P450-independent metabolization, intravenous lormetazepam might be clinically advantageous compared to midazolam. In this retrospective cohort study, we compared patients who received either intravenous lormetazepam or midazolam with respect to their survival and sedation characteristics. The cohort included 3314 mechanically ventilated, critically ill patients that received one of the two drugs in a tertiary medical center in Germany between 2006 and 2018. A Cox proportional hazards model with mortality as outcome and APACHE II, age, gender, and admission mode as covariates revealed a hazard ratio of 1.75 [95% CI 1.46–2.09; p < 0.001] for in-hospital mortality associated with the use of midazolam. After additionally adjusting for sedation intensity, the HR became 1.04 [95% CI 0.83–1.31; p = 0.97]. Thus, we concluded that excessive sedation occurs more frequently in critically ill patients treated with midazolam than in patients treated with lormetazepam. These findings require further investigation in prospective trials to assess if lormetazepam, due to its ability to maintain light sedation, might be favorable over other benzodiazepines for sedation in the ICU.
Objective:
to carry out a theoretical reflection on the Nursing Now Campaign and the experience of the unexpected irruptions facing the pandemic period.
Method:
a theoretical-reflective study, supported by the theoretical framework of complexity thinking. It aims at understanding the dialogic between the notions of order, disorder and organization, which translate the transition from simplification to complexity of the pandemic phenomenon and its relation to the theme of Nursing Now and Nursing in the future.
Results:
the universe of phenomena is simultaneously composed of order, disorder and organization. Reasserting the central role of Nursing in the health team, facing the irruptions and uncertainties caused by the current pandemic, implies the ability to dialog with disorder and raise a new and more complex global (re)organization of the being and doing Nursing.
Conclusion:
in addition to answers, theoretical reflection raises new questions and irruptions. The inseparability between the notions of order and disorder in the evolutionary dynamics of the Nursing system is conceived and the promotion of even more complex levels of organization, management and Nursing assistance to achieve universal access to health is advocated.
Objective
Brass players are exposed to high musculoskeletal strains during their instrumental play. Various assessments can be used to measure these strains, whereby a targeted therapy can also be supported. The aim of this study was to review literature concerning assessments used in quantitatively based studies about the analysis of musculoskeletal loads of brass players.
Data sources
The Cochrane Library, PubMed, CINAHL, PEDro as well as the journal “Medical Problems of Performing Artists” were searched for relevant studies.
Study selection
Two reviewers independently applied the inclusion and exclusion criteria to select potential studies. A third reviewer was involved in the case of discrepancies.
Data extraction
Two reviewers independently extracted the data.
Data synthesis
A total of 73 studies conducted between 2004 and 2019 were included. Within a total of 30 studies, 18 assessments could be found that collect 2-dimensional or 3-dimensional kinematic data using video- or image-based analysis of posture, sonographic, optoelectronic and various electromagnetic systems. In 7 studies kinetic data were measured by force-transducers, pressure platforms, stabilizer and dynamometer. Fifteen studies used clinical examinations and additional assessments to screen individual body regions and 9 studies derived electromyography measurements from a total of 25 muscles. Thirty-one partially validated questionnaires were used to record musculoskeletal pain of brass players.
Conclusions
A variety of assessments can be used to optimize analysis and treatment procedures in research and clinical work. Future studies should both examine quality criteria of the various assessment methods and validate clinical examinations and questionnaires.
Purpose
This paper aims to investigate the strategic consequences of manufacturing location decisions, with a focus on understanding the link between collocating manufacturing with other value chain activities, via reshoring or retaining and organizational agility.
Design/methodology/approach
The paper uses qualitative data from 115 interviews with executives from UK high value manufacturing companies to explore the recent phenomenon of reshoring and the strategic effects of manufacturing location.
Findings
The location of manufacturing is operationally and strategically important for multinational companies. The spatial dispersion of manufacturing is determined by firm-specific and external factors, both of which are subject to constant change. The analysis shows that concentrating on manufacturing in their home countries enables firms to increase organizational agility and stimulate innovation. Better integration with and more extensive collaboration between related value chain activities, such as research and development, sales and marketing, leads to higher flexibility, speed and responsiveness to customer requirements. However, under certain conditions, firms also continue to benefit from the known advantages of offshoring.
Originality/value
This research sheds light on possible strategic downsides of global value chains, characterized by dispersed activities and intermitted processes. The results provide evidence that retaining manufacturing or bringing back manufacturing operations to a company’s home country can increase organizational flexibility, speed, adaptability, innovativeness and responsiveness to customer requirements. As these capabilities are critical for long-term survival, especially in dynamic environments, firms need to review their global factory configurations and determine whether the short-term advantages of foreign locations continue to justify offshoring practices.